Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Jornal Vascular Brasileiro (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492015000100016 |
Resumo: | BACKGROUND: The diagnosis of lymphedema can be obtained objectively by measurement methods, and also by subjective methods, based on the patient's complaint. OBJECTIVE: To evaluate inter-rater reliability of objective and subjective criteria used for diagnosis of lymphedema and to propose a lymphedema cut-off for differences in volume between affected and control limbs. METHODS: We studied 84 patients who had undergone lymphadenectomy for treatment of cutaneous melanoma. Physical measures were obtained by manual perimetry (MP). The subjective criteria analyzed were clinical diagnosis of lymphedema in patients' medical records and self-report of feelings of heaviness and/or increase in volume in the affected limb. RESULTS: For upper limbs, the subjective criteria clinical observation (k 0.754, P<0.001) and heaviness and swelling (k 0.689, P<0.001) both exhibited strong agreement with MP results and there was moderate agreement between MP results and swelling (k 0.483 P<0.001), heaviness (k 0.576, P<0.001) and heaviness or swelling (k 0.412, P=0.001). For lower limbs there was moderate agreement between MP results and clinical observation (k 0.423, P=0.003) and regular agreement between MP and self-report of swelling (k 0.383, P=0.003). Cut-off values for diagnosing lymphedema were defined as a 9.7% difference between an affected upper limb and control upper limb and a 5.7% difference between lower limbs. CONCLUSION: Manual perimetry, medical criteria, and self-report of heaviness and/or swelling exhibited better agreement for upper limbs than for lower limbs for diagnosis of lymphedema. |
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Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbslymphedemadiagnosismethods BACKGROUND: The diagnosis of lymphedema can be obtained objectively by measurement methods, and also by subjective methods, based on the patient's complaint. OBJECTIVE: To evaluate inter-rater reliability of objective and subjective criteria used for diagnosis of lymphedema and to propose a lymphedema cut-off for differences in volume between affected and control limbs. METHODS: We studied 84 patients who had undergone lymphadenectomy for treatment of cutaneous melanoma. Physical measures were obtained by manual perimetry (MP). The subjective criteria analyzed were clinical diagnosis of lymphedema in patients' medical records and self-report of feelings of heaviness and/or increase in volume in the affected limb. RESULTS: For upper limbs, the subjective criteria clinical observation (k 0.754, P<0.001) and heaviness and swelling (k 0.689, P<0.001) both exhibited strong agreement with MP results and there was moderate agreement between MP results and swelling (k 0.483 P<0.001), heaviness (k 0.576, P<0.001) and heaviness or swelling (k 0.412, P=0.001). For lower limbs there was moderate agreement between MP results and clinical observation (k 0.423, P=0.003) and regular agreement between MP and self-report of swelling (k 0.383, P=0.003). Cut-off values for diagnosing lymphedema were defined as a 9.7% difference between an affected upper limb and control upper limb and a 5.7% difference between lower limbs. CONCLUSION: Manual perimetry, medical criteria, and self-report of heaviness and/or swelling exhibited better agreement for upper limbs than for lower limbs for diagnosis of lymphedema. Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)2015-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492015000100016Jornal Vascular Brasileiro v.14 n.1 2015reponame:Jornal Vascular Brasileiro (Online)instname:Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)instacron:SBACV10.1590/1677-5449.20140037info:eu-repo/semantics/openAccessCampanholi,Larissa LouiseDuprat Neto,João PedreiraFregnani,José Humberto Tavares Guerreiroeng2015-08-04T00:00:00Zoai:scielo:S1677-54492015000100016Revistahttp://www.scielo.br/jvbhttps://old.scielo.br/oai/scielo-oai.php||secretaria@sbacv.org.br1677-73011677-5449opendoar:2015-08-04T00:00Jornal Vascular Brasileiro (Online) - Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)false |
dc.title.none.fl_str_mv |
Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs |
title |
Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs |
spellingShingle |
Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs Campanholi,Larissa Louise lymphedema diagnosis methods |
title_short |
Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs |
title_full |
Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs |
title_fullStr |
Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs |
title_full_unstemmed |
Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs |
title_sort |
Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs |
author |
Campanholi,Larissa Louise |
author_facet |
Campanholi,Larissa Louise Duprat Neto,João Pedreira Fregnani,José Humberto Tavares Guerreiro |
author_role |
author |
author2 |
Duprat Neto,João Pedreira Fregnani,José Humberto Tavares Guerreiro |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Campanholi,Larissa Louise Duprat Neto,João Pedreira Fregnani,José Humberto Tavares Guerreiro |
dc.subject.por.fl_str_mv |
lymphedema diagnosis methods |
topic |
lymphedema diagnosis methods |
description |
BACKGROUND: The diagnosis of lymphedema can be obtained objectively by measurement methods, and also by subjective methods, based on the patient's complaint. OBJECTIVE: To evaluate inter-rater reliability of objective and subjective criteria used for diagnosis of lymphedema and to propose a lymphedema cut-off for differences in volume between affected and control limbs. METHODS: We studied 84 patients who had undergone lymphadenectomy for treatment of cutaneous melanoma. Physical measures were obtained by manual perimetry (MP). The subjective criteria analyzed were clinical diagnosis of lymphedema in patients' medical records and self-report of feelings of heaviness and/or increase in volume in the affected limb. RESULTS: For upper limbs, the subjective criteria clinical observation (k 0.754, P<0.001) and heaviness and swelling (k 0.689, P<0.001) both exhibited strong agreement with MP results and there was moderate agreement between MP results and swelling (k 0.483 P<0.001), heaviness (k 0.576, P<0.001) and heaviness or swelling (k 0.412, P=0.001). For lower limbs there was moderate agreement between MP results and clinical observation (k 0.423, P=0.003) and regular agreement between MP and self-report of swelling (k 0.383, P=0.003). Cut-off values for diagnosing lymphedema were defined as a 9.7% difference between an affected upper limb and control upper limb and a 5.7% difference between lower limbs. CONCLUSION: Manual perimetry, medical criteria, and self-report of heaviness and/or swelling exhibited better agreement for upper limbs than for lower limbs for diagnosis of lymphedema. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-03-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492015000100016 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492015000100016 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1677-5449.20140037 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) |
publisher.none.fl_str_mv |
Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) |
dc.source.none.fl_str_mv |
Jornal Vascular Brasileiro v.14 n.1 2015 reponame:Jornal Vascular Brasileiro (Online) instname:Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) instacron:SBACV |
instname_str |
Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) |
instacron_str |
SBACV |
institution |
SBACV |
reponame_str |
Jornal Vascular Brasileiro (Online) |
collection |
Jornal Vascular Brasileiro (Online) |
repository.name.fl_str_mv |
Jornal Vascular Brasileiro (Online) - Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) |
repository.mail.fl_str_mv |
||secretaria@sbacv.org.br |
_version_ |
1752126646915170304 |